Healthcare Provider Details

I. General information

NPI: 1821728056
Provider Name (Legal Business Name): HEALING THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2022
Last Update Date: 06/11/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 ALLIED DR STE 303
DEDHAM MA
02026-6148
US

IV. Provider business mailing address

64 FLEMING ST
DEDHAM MA
02026-2524
US

V. Phone/Fax

Practice location:
  • Phone: 774-234-7589
  • Fax:
Mailing address:
  • Phone: 207-590-4112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MELANIE HANNON
Title or Position: OWNER
Credential: LICSW LADC
Phone: 207-590-4112